Introduction:

Iron deficiency anaemia is the most common cause of anaemia in pregnancy and is a major cause of maternal mortality worldwide (Omotayo et al., 2021). In clinical practice this is treated with intravenous iron if oral iron has failed or is contraindicated, or a rapid increase in iron levels is required. This audit was created due to concerns that there were anecdotally a high rate of complications and side effects after administration of Monofer ® in the Rosie hospital.

 

Methodology:

The case notes of the last 50 women to receive Monofer® in the Rosie Hospital, Cambridge, were examined. The outcomes of treatment of iron deficiency anaemia with Monofer® were assessed in relation to local guidance.

 

Conclusions:

Our results show that a lot of Monofer ® is being given postnatally, and largely due to post-partum haemorrhage. Severe anaemia has been shown to be a risk factor for post-partum haemorrhage (Omotayo et al., 2021) and thus by better monitoring patients antenatally we could potentially decrease the number of patients needing Monofer ® postnatally. The number of patients experiencing an adverse drug reaction to Monofer ® in this cohort was 12.2%, which is comparable to that found in the general literature (Fung et al., 2022)(Gybel-Brask et al., 2018). The most common adverse drug reaction in our cohort was the Fishbane reaction, seen in 4.9% of people. Other side effects noted were blood pressure changes and dizziness. A major finding of this audit is that only 19.5% of the entire cohort were given Monofer ® according to the local guidelines. This was largely due to the Ferritin levels not being checked (36.6%) though haemoglobin levels were found to be higher than 105g/L in 12.2% of the cohort. Given that Ferritin levels were only checked in 36.6% of the cohort we are risking iron overloading patients when they might require different supplementation such as B12 instead of iron.